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I just started the Sustiva+Truvada Combo 2 nights ago after years of Trizivir and Viread+Combivir and am now trying to adapt to the new side effects (Doc and I decided to try the switch because I have no more body fat (except for a slight potbelly) and the sunken in eyes, cheeks, butt and the fact that my veins are huge on the surface of my skin on my arms and legs).

First off, thanks all of you for a really informative website and forum which I wish I'd of discovered years ago - one can spend hours immersed in all the data and feedback (which I have in the last few days), but the "need for speed" for answers requires that I ask directly instead.

So far (OK, 2 nights, still too early to tell!) I am adapting well to Sustiva, except for the drunk/drugged feeling: it's fine at home and nights, but I'm worried about work.I am a corporate manager of a bank group and cannot afford acting drunk or drugged at work (I'd fire me...)

I started the new combo on a Friday night to have the weekend to adapt, but Monday morning it's back to the bank where I can not afford to crash into walls at 9 in the morning because I appear drunk. Seems it takes a good 10-12 hours for this to wear off at the moment... will this time shorten? it this temporary? Am I foggy and wobbly in future for a set number of hours after taking the med, or is it more like a set number of hours after waking up again - should I just get up earlier to "sober up" before work?

I took the meds when I went to bed around midnight Friday and Saturday, drank zero booze and avoided food (incl. snacks) 3 hours before bedtime to minimize side effects, and got up at 10 yesterday ("drunk" til noon) and 11 today (by the way, I haven't slept this well in years!) and am trying to type this now (noon) with one eye squeezed shut focussing on the keys, but am fighting - and retyping a lot of words as I go along.

If I take the meds earlier in the evening, I can kiss my evenings goodbye ... woozytime for bozo starts about 30 minutes after I take the meds .. again, I can deal if it's a week or two to adapt, and it is then replaced with a "sober when the alarm clock rings at 7 am" - but if this keeps up, it's the end of sustiva for me... which would be a shame, cause it's kind of a nice way to relax on a Friday night

Thanks to any who have been through this and give give an idea of how this might develop/diminish in the near future!

Mark

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First Tested Positive: March 27 1998Crashed on May 23,'98: hospitalized with PCP & HIV stage C3: CD4 70 (8%) and over 1 million nasty critters at start / 692000 @ release from hospital 17 days later. Started the Epivir+Zerit+Norvir+Fortovase cocktail and dropped to 580 (1 month) to 60 (3months) to <50 (6 months). 3 yrs later switched to Trizivir, then to Combivir+Viread. Tried Sustiva & Truvada 6 months, now on Viramune+Truvada

The offender in your case is Sustiva, which is quite notorious for it's "head" symptoms. A sense of "drunkeness" such as you report is very common as are sleep disturbances, vivid dreams and less commonly mood problems.

For most people these effects subside within a few weeks and given you've been on Sustiva for only a couple of days it really is worth persevering. Sustiva is a potent anti-viral with an excellent reputation for viral suppression.

Nevertheless, as you note side effects which impact on your performance at work are not acceptable and my advice would be to discuss this matter with your doctor ASAP. If these things don't improve there are other treatment options available.

Thanks. I guess the most important question that I have is regarding how to stop the drugged up feeling as quickly as possible in the mornings - is it more a "fixed number of hours after taking meds" thing, which would require taking the meds earlier in the evening (and then going to bed earlier), or is it more like a "2 hours after waking" thing that I can influence by getting up earlier?I'd hate to have to "go to bed at latest 8 pm on a school night" - fought that 30 years ago, and I'd fight it today!

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First Tested Positive: March 27 1998Crashed on May 23,'98: hospitalized with PCP & HIV stage C3: CD4 70 (8%) and over 1 million nasty critters at start / 692000 @ release from hospital 17 days later. Started the Epivir+Zerit+Norvir+Fortovase cocktail and dropped to 580 (1 month) to 60 (3months) to <50 (6 months). 3 yrs later switched to Trizivir, then to Combivir+Viread. Tried Sustiva & Truvada 6 months, now on Viramune+Truvada

I also had the drunken sensations (actually, it was more like coming up on a couple of Es) when I first started on that same combo, but after a few weeks it faded to a hot flush .. and then nothing at all by about six weeks.

What I found to be the most effective way to combat the morning after feeling was to keep my evening meal as low in fat as possible and to eat it a good four hours before taking my meds (fat increases the blood levels of the Sustiva to well above therapeutic levels and thus exaggerates and prolongs the sensation of being drunk during those first few weeks).

If the course of your acclimatisation is anything like mine, then it will only take a couple of days for the morning sensations to fade to feeling a little groggy for the first hour or so that you are awake (and after a couple of weeks, nothing at all).

I donít know anyone who has started on that combo and not felt exactly the same as you do, so rest assured that what you are experiencing is perfectly normal .. and WILL fade dramatically.

Everyone responds to Sustiva differently but most get over the "drunk" feeling in the first couple of weeks. The key things is to keep your dinner light and low-fat. Also, make sure you have two hours (minimum) before taking Sustiva. In the mornings, I have discovered a strong cup of coffee is the key to get any cobwebs out of my brain and get the day moving. You said, you noticed it takes 10-12 hours before it lifts, then I might suggest eating dinner earlier and taking the pill sooner getting a good nights sleep (at least 8 hours).

If it bothers you, check with your doc and see the other options available.

i take mine at 9 pm then feel sleepy about 1030 pm ...wake up for work at 430am and don't feel drunk at all...but my nite life isn't what it used to be!! have to call it quits at about 1030pm if out with friends because of the sleepyness....

Looks like I may be the first female to reply here, but I have been on Sustiva for five years. I get the drunk feeling every damn night and it has never gone away. I have found that if I am up, say posting in the Forums when it hits me, I can kind of work through it. I'm still foggy afterwards and then go to bed, but its nothing like the initial wave. However, if I take the med and go to bed soon after, I find that I can wake up in the middle of the night and still have the drunk feeling. I imagine this is because my metabolism has slowed down while sleeping, or maybe I've eaten too much fat in the evening.

Some people I know are foggy in the morning, and I guess I am too, but I chug a Diet Coke and work through it. I find that getting ready for work and being awake tend to burn the side effects out of my system.

Also, no VL detectable ever in the five years that I have been on Sustiva, so I think I may just have to stay on it!

thanks all - so far, so good!Woozy feeling a little less each day - I'm finding that lots of light (I turn on all lights in hall & bathroom now) and the shower does wonders to wake me up.Coffee consumption has shot upwards, though.Other than that: one odd hot flash midday on Tuesday - kina like a Niacin flush, lasted 1 minute or so... that's it so far.Keeping fingers crossed - Doc say, if no reactions within 1st 3 weeks, all's well...

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First Tested Positive: March 27 1998Crashed on May 23,'98: hospitalized with PCP & HIV stage C3: CD4 70 (8%) and over 1 million nasty critters at start / 692000 @ release from hospital 17 days later. Started the Epivir+Zerit+Norvir+Fortovase cocktail and dropped to 580 (1 month) to 60 (3months) to <50 (6 months). 3 yrs later switched to Trizivir, then to Combivir+Viread. Tried Sustiva & Truvada 6 months, now on Viramune+Truvada

I am so happy I found this website! I've been positive for 7+ years and only just signed up yesterday. Anyway, my reason for posting is that I just started the Sustive & Truvada combo on the 15th and am having the same "drunk/woozy" feeling. I love that it helps put me to sleep because I go to bed early anyway. I get up ok, but after the "rush" of getting me and my kid out the door for the day...I get to work and feel like I need to lay down.

Thank you all for your posts and suggestions.

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Life is not measured by the number of breaths we take, but by the number of moments that take our breath away.-Auther unknown

I have been on Atripla 3 weeks and the morning fog is still there a little. I have found that. Not eating for 4 hours before bed, getting as close to 8 hrs sleep as possible, and working out helps a lot. I could not work out for two weeks becasue of a allergic reaction to Bactrim and the foggy feeling was much more noticable. From what I have read, doing cardio and resistance training really helps with everything related to HIV/AIDS. I have been working out for years but have started doing it every other day and I can feel the difference. I have only been diagnosed since July but have been reading alot, talking to everyone I can, and AIDSmeds and Poz.com have really helped with my questions and concerns. Kevin

Sustiva knocks me on my ass about an hour after taking it - at least it did when I was taking Combivir + Sustiva. One thought... since you are taking Truvada + Combivir, have you considered switching to Atripla? I find that the switch to Atripla changed my reaction to Combivir. Not sure why, but I don't get as drunk, and it doesn't last as long when I take Atripla, even though it still has 600mg of Sustiva in it.

Perhaps something with how they combine the medications in a single pill?

After 6 months of "drunk at work" with several flashes and dizzy spells hitting with no warning during the day, the doc and I decided to give up on Sustiva... works well for many, didn't work for me. Doc says the problems everyone has at the beginning go away most of the time, but her experience is that they stay for about 20% of her patients: they try for months, but eventually give up!Am now starting VIRAMUNE + TRUVADA ... wish me luck!

Logged

First Tested Positive: March 27 1998Crashed on May 23,'98: hospitalized with PCP & HIV stage C3: CD4 70 (8%) and over 1 million nasty critters at start / 692000 @ release from hospital 17 days later. Started the Epivir+Zerit+Norvir+Fortovase cocktail and dropped to 580 (1 month) to 60 (3months) to <50 (6 months). 3 yrs later switched to Trizivir, then to Combivir+Viread. Tried Sustiva & Truvada 6 months, now on Viramune+Truvada

Thanks Newt!...that is one word that has really nasty side effects - Sustiva's dizzy spells are nothing to a banker compared to those you get from hearing the word "mortgage"!

Logged

First Tested Positive: March 27 1998Crashed on May 23,'98: hospitalized with PCP & HIV stage C3: CD4 70 (8%) and over 1 million nasty critters at start / 692000 @ release from hospital 17 days later. Started the Epivir+Zerit+Norvir+Fortovase cocktail and dropped to 580 (1 month) to 60 (3months) to <50 (6 months). 3 yrs later switched to Trizivir, then to Combivir+Viread. Tried Sustiva & Truvada 6 months, now on Viramune+Truvada

Sustiva used to knock me out when i started my meds. I kind of enjoyed the side effects as i was able to sleep very well. This side effects only lasted couple of months. Now weather i take the pill on empty stomach or with food , no side affect.

All i can say is "Enjoy the side effect of sustiva while it lasts...."